Question:

Is vulnerable plaque different from regular plaque (as in coronary arteries?)

Read your article on “Vulnerable Plaque”. How recently has this development come about? I asked my Cardiologist if I had vulnerable plaque and was told that, of course I had plaque, that is why two stents were inserted. I am under the impression that vulnerable plaque is a completely different animal than regular plaque. Am I wrong? I can’t help but wonder if perhaps my Cardiologist is not current on this development. When I mentioned that I was reading about it and that it was a fairly recent development, she looked at me like I was, well, less than intelligent. (To be nice here!) Thank you in advance for any help you can give me on this.

Submitted by Daniel from Columbia, South Carolina on 05/03/2015

Answer:
by James T. Willerson, MD

You are correct. A vulnerable plaque is one prone to rupture because it is inflamed and the rupture of the plaque causes an occlusive thrombus to develop obstructing the lumen of a coronary artery leading to an immediate heart attack, and many times, sudden death. Other plaques are stable and may remain stable for long periods of time or may gradually grow and narrow the lumen of a coronary artery to a point where one has chest discomfort “angina” when one walks rapidly, becomes upset, is in cold weather, walks up an incline, or after a big meal. When the patient becomes symptomatic in this manner, he or she often have a stent or stents placed in the artery that is severely narrowed. Today, patients with heart attacks from a vulnerable plaque that ruptured often receive coronary stents as well.